[Editor's note: Dr. Harise Stein at Stanford University edits a web site -- abuseresearch.info -- that focuses on the health effects of abuse, and includes research articles on ACEs. Every month, she posts the summaries of the abstracts and links to research articles that address only ACEs. Thank you, Harise!! -- Jane Stevens]
Strathearn L, Giannotti M, Mills R, et. al.
Long-term Cognitive, Psychological, and Health Outcomes Associated With Child Abuse and Neglect. Pediatrics. 2020 Oct;146(4):e20200438. PMID: 32943535
“Overall, psychological maltreatment [emotional abuse and/or neglect] was associated with the greatest number of adverse outcomes in almost all areas of assessment.” Various forms of abuse were associated with early sexual debut and youth pregnancy, miscarriage, attention problems, PTSD symptoms, depression, externalizing behavior problems, delinquency, drug abuse, psychosis, asthma symptoms, and significant cognitive delays and educational failure.
Hardcastle K, Bellis MA, Sharp CA, Hughes K.
Exploring the health and service utilisation of general practice patients with a history of adverse childhood experiences (ACEs). BMJ Open. 2020 Sep 25;10(9):e036239. PMID: 32978186
Using electronic health records for 763 UK general practice patients, “A history of ACEs was strongly independently associated with current mental health problems, smoking and chronic obstructive pulmonary disease, showing a dose-response relationship with level of ACE exposure. Medication use and contact were significantly greater among patients with high ACE exposure (≥4 ACEs), compared with those with no ACEs.”
Racine N, McDonald S, Chaput K, Tough S, Madigan S.
Maternal substance use in pregnancy: Differential prediction by childhood adversity subtypes. Prev Med. 2020 Dec;141:106303. PMID: 33121963
“Substance use in pregnancy, including alcohol use, drug use, or smoking, is associated with poor health outcomes for both the mother and her unborn child.” Of 1994 Canadian pregnant women, self-report of a personal history of childhood household-dysfunction ACEs and total ACEs, but not physical or sexual violent ACEs, were positively associated with substance use behaviors in pregnancy.
Hein TC, Muz B, Ahmadi-Montecalvo H, Smith T.
Associations among ACEs, Health Behavior, and Veteran Health by Service Era. Am J Health Behav. 2020 Nov 1;44(6):876-892. PMID: 33081883
While US veterans from any service era who reported ACEs also reported similar negative effects on mental and physical health, draft era veterans experienced the fewest ACEs (mean 1.04) while volunteer era veterans experienced the most ACEs (2.42).
Williams BW.
Professionalism Lapses and Adverse Childhood Experiences: Reflections from the Island of Last Resort. Acad Med. 2019 Aug;94(8):1081-1083. PMID: 31094726
“This Invited Commentary highlights the prevalence of adverse childhood experiences and the potential effect that such experiences can have in the medical education setting on trainees, colleagues, and faculty”, including disruptive behavior, mental health issues, problems with boundaries and trust, and lack of reciprocity and attunement with others’ emotional states. “Given the documented high proportion of health care workers, including physicians, who are trauma survivors, trauma-sensitive education must be a priority, not only in medical school but across the educational continuum.”
Malhi N, Oliffe JL, Bungay V, Kelly MT.
Male Perpetration of Adolescent Dating Violence: A Scoping Review. Am J Mens Health. 2020 Sep-Oct;14(5):1557988320963600. PMID: 33045903
From a research review of male perpetration of adolescent dating violence, three factors emerged that increased the risk of perpetration: “male entitlement and gender norms that endorse power and control over females; adverse childhood experiences, especially witnessing or experiencing violent behavior in the home, school, or community; and poor conflict resolution skills and emotion dysregulation.”
Chokshi B, Chen KD, Beers L.
Interactive Case-Based Childhood Adversity and Trauma-Informed Care Electronic Modules for Pediatric Primary Care. MedEdPORTAL. 2020 Oct 12;16:10990. PMID: 33094156
Four modules were created to educate health professionals in childhood adversity and trauma-informed care – introduction to ACEs, the principles of trauma-informed care, components of childhood resilience building, and approaching ACEs in the pediatric setting. Full text and downloadable module contents.
Kuzma EK, Pardee M, Morgan A.
Implementing Patient-Centered Trauma-Informed Care for the Perinatal Nurse. J Perinat Neonatal Nurs. 2020 Oct/Dec;34(4):E23-E31. PMID: 33079811
“Adverse childhood experiences and trauma significantly impact physical and mental health. Increased maternal perinatal depression/anxiety, preterm labor, and low birth weight, as well as infant morbidity and mortality, are some examples of the impact of trauma on perinatal health. Trauma-informed care begins with knowledge about trauma, the ability to recognize signs of a trauma response, responding to patients effectively, and resisting retraumatization.”
Srivastav A, Strompolis M, Moseley A, Daniels K.
The Empower Action Model: A Framework for Preventing Adverse Childhood Experiences by Promoting Health, Equity, and Well-Being Across the Life Span. Health Promot Pract. 2020 Jul;21(4):525-534. PMID: 31760809
(Also of related interest without using “ACE”) Reibling ET, Distelberg B, Guptill M, Hernandez BC.
Intimate Partner Violence Experienced by Physicians. J Prim Care Community Health. 2020 Jan-Dec;11:2150132720965077. PMID: 33078671
From a survey of 400 male and female physicians, residents and fellows, 24.0% reported lifetime IPV – 14.8% verbal abuse, 7.5% physical, 4.0% sexual, and 3.8% stalking. There were no differences in professional roles or work settings. 7% reported a subsequent relationship also marked by IPV. Early childhood abuse was a significant predictor of reporting IPV later in life. Women and Asian Americans reported slightly higher IPV rates. This study has implications for medical education personally as well as care of colleagues, and may influence the ability to deliver patient care. “Workplace interventions are needed to support physicians while protecting their license, reputation, and physical/emotional safety.”
Dias A, Mooren T, Kleber RJ.
Reducing consequences of child maltreatment during adulthood by public health actions: a Delphi study. Eur J Public Health. 2019 Jun 1;29(3):425-431. PMID: 30312403
A consensus discussion from 91 mainly European professionals, researchers and clinicians about potential public health actions to mitigate childhood maltreatment (CM) consequences during adulthood included: prioritization of increasing community awareness and training emotional regulation in affected adults, enlarging curricular knowledge about CM for professionals, developing evidence-based interventions, and reducing the barriers for access to interventions for adults.
Spehr MK, Zeno R, Warren B, Lusk P, Masciola R.
Social-Emotional Screening Protocol Implementation: A Trauma-Informed Response for Young Children in Child Welfare. J Pediatr Health Care. 2019 Nov-Dec;33(6):675-683. PMID: 31256851
“This quality improvement pilot project implemented an evidence-based social-emotional screening protocol for very young children placed in out-of-home care through the county's child welfare system. Findings showed significant improvement in identification of children younger than 3 years with social-emotional concerns, and significant improvement in referral of those children positively identified.”
Taylor JK.
Structural Racism and Maternal Health Among Black Women. J Law Med Ethics. 2020 Sep;48(3):506-517. PMID: 33021163
Article focuses on “the historical foundations of racism and reproductive oppression as a way to set the stage for manifestations of structural racism seen in the present ongoing patterns of persistent racial inequity in health care, all of which have led to vast racial disparities in maternal health and poor pregnancy-related outcomes among Black women. Provider bias and racism within the health care system are important contributors, as well as policy restrictions that undermine health care access.”
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